Low Vitality Score at Birth Associated with Cerebral Palsy Risk

But 90 percent with low scores did not develop the disease, researchers said

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FRIDAY, Oct. 8, 2010 (HealthDay News) -- A low vitality score at birth is strongly associated with a later diagnosis of cerebral palsy, a disorder involving muscle impairment and body movement that appears during the first few years of life, a new study indicates.

The Apgar score (zero to 10) is based on five vitality-related criteria -- complexion, pulse rate, reaction when stimulated, muscle tone, and breathing. An Apgar score of 3 or less is regarded as critically low, 4 to 6 is fairly low, and 7 to 10 is generally normal.

For this study, researchers examined data from 543,064 Norwegian children born between 1986 and 1995. Of those children, 988 (1.8 in 1,000) were diagnosed with cerebral palsy before they were 5 years old. (In Western countries, cerebral palsy generally affects two to three children out of every 1,000 born.)

The researchers found that children with an Apgar score of less than 3 at birth had a 100-fold higher incidence of cerebral palsy than those with a score of 10. The association between a low Apgar score and cerebral palsy was high in children with normal birth weight and modest in children with low birth weight.

"Despite the strong association of low Apgar score with cerebral palsy, it is encouraging that almost 90 percent of children with an Apgar score of less than 4 did not develop cerebral palsy," the researchers wrote.

They said their findings suggest that the causes of cerebral palsy are closely associated with factors that reduce infant vitality, they concluded. They suggested that a low Apgar score may sometimes indicate brain impairment that occurred during pregnancy or delivery.

In an accompanying editorial, professor Nigel Paneth of Michigan State University said that although most babies with a low Apgar score recover and do well, infants with a low score "should be watched closely for the persistence or development of brain damage, especially in the light of robust evidence that babies with brain injury may benefit from head or body cooling."